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1型强直性肌营养不良症胚胎植入前基因检测中的卵巢反应

Ovarian response in preimplantation genetic testing for myotonic dystrophy type 1.

作者信息

Sonigo Charlotte, Ranisavljevic Noémie, Guigui Mathilde, Anahory Tal, Mayeur Anne, Moutou Céline, Rongières Catherine, Reignier Arnaud, Leperlier Florence, Melaye Gaelle, Girardet Anne, Ray Pierre F, Steffann Julie, Pirrello Olivier, Grynberg Michaël

机构信息

Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Antoine Béclère, Université Paris-Saclay, Assistance Publique Hôpitaux de Paris, F-92140, Clamart, France.

Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Antoine Béclère, 157 Avenue de la Porte Trivaux, 92140, Clamart, France.

出版信息

J Assist Reprod Genet. 2025 Jan;42(1):185-192. doi: 10.1007/s10815-024-03324-1. Epub 2024 Dec 22.

Abstract

PURPOSE

To evaluate ovarian stimulation response in couples undergoing preimplantation genetic testing (PGT-M) for myotonic dystrophy type 1 (DM1) METHODS: Retrospective, observational, multicentric study. Parameters of ovarian response and PGT-M outcomes were compared according to the DM1-affected patient (female or male). A total of 229 couples underwent at least one controlled ovarian hyperstimulation cycle for the PGT-M procedure. Overall, 678 COS cycles were started, leading to 560 cycles with oocyte retrievals and subsequent PGT-M analysis.

RESULTS

At the time of the first PGT-M attempt, affected DM1 females were 1 year older and their serum AMH level was significantly lower than that of the healthy partner of affected DM1 males. After higher starting and total doses of exogenous gonadotropins, the number of mature oocytes was not statistically different between both groups (9 [6-13] vs 9 [6-13] mature oocytes, p=0.73). The FORT index was similar in both groups (35.2% [19.2-52.8] vs 33.3% [19.6-50.0], p=0.09), suggesting that antral follicle responsiveness to FSH is not altered. The live birth rate per fresh embryo transfer was 23.8% in the affected females group and 27.6% for the affected males.

CONCLUSION

After adapted controlled ovarian stimulation protocol and starting dose, a similar response (number of mature oocytes) and sensitivity (FORT index) was observed in DM1 females when compared to healthy partners of DM1 males undergoing PGT-M.

摘要

目的

评估进行1型强直性肌营养不良(DM1)植入前基因检测(PGT-M)的夫妇的卵巢刺激反应。方法:回顾性、观察性、多中心研究。根据受DM1影响的患者(女性或男性)比较卵巢反应参数和PGT-M结果。共有229对夫妇因PGT-M程序接受了至少一个控制性卵巢过度刺激周期。总体而言,启动了678个COS周期,导致560个周期进行了卵母细胞采集及随后的PGT-M分析。

结果

在首次进行PGT-M尝试时,受DM1影响的女性比受DM1影响的男性的健康伴侣年长1岁,且其血清AMH水平显著更低。在使用更高的外源性促性腺激素起始剂量和总剂量后,两组之间成熟卵母细胞的数量无统计学差异(分别为9个[6 - 13个]成熟卵母细胞与9个[6 - 13个]成熟卵母细胞,p = 0.73)。两组的FORT指数相似(分别为35.2%[19.2 - 52.8]与33.3%[19.6 - 50.0],p = 0.09),表明窦卵泡对FSH的反应性未改变。受影响女性组每新鲜胚胎移植的活产率为23.8%,受影响男性组为27.6%。

结论

在采用适应性控制性卵巢刺激方案和起始剂量后,与接受PGT-M的DM1男性的健康伴侣相比,DM1女性观察到了相似的反应(成熟卵母细胞数量)和敏感性(FORT指数)。

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